title: Cognitive function is a risk for health literacy in older adults with diabetes.
abstract: OBJECTIVE
  Cognitive impairment is common in older adults with diabetes, yet it is unclear to what extent cognitive function is associated with health literacy. We hypothesized that cognitive function, independent of education, is associated with health literacy.
  
  
  METHODS
  The sample included 537 African American, American Indian, and White men and women 60 years or older. Measures of cognitive function included the Mini-Mental State Examination (MMSE), Verbal Fluency, Brief Attention, and Digit Span Backward tests. Health literacy was assessed using the S-TOFHLA.
  
  
  RESULTS
  Cognitive function was associated with health literacy, independent of education and other important confounders. Every unit increase in the MMSE, Digit Span Backward, Verbal Fluency or Brief Attention was associated with a 20% (p<.001), 34% (p<.001), 5% (p<.01), and 16% (p<.01) increase in the odds of having adequate health literacy, respectively.
  
  
  CONCLUSIONS
  These results suggest that cognitive function is associated with health literacy in older adults with diabetes. Because poor cognitive function may undermine health literacy, efforts to target older adults on improving health literacy should consider cognitive function as a risk factor.
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States. hnguyen@wakehealth.edu
authors.forename: Ha T
authors.initials: HT
authors.lastname: Nguyen
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Grzywacz
authors.forename: Santiago J
authors.initials: SJ
authors.lastname: Saldana
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: Cognition; Diabetes; Health literacy